What are the Pathological/Histological Changes To The Periodontium From Disease during Early Gingivitis (EARLY LESION) 1. Bacterial/Cellular Features 2. Tissue Level 3. Clinical Features/Time

1. - Bacteria accumulates and subgingival plaque biofilm maturation occurs. - Migration, infiltration and production of white blood cells/chemical defenders (leukocytes, neutrophils-PMNs, macrophages, cytokines, PGE2, MMPs, lymphocytes, T-Cells, antibodies and some plasma cells) into the connective tissue. Response causes cytokines and PMNs to destroy connective tissue. - Gingivitis is reversible when biofilm is controlled and inflammation is reduced, if not progression to established gingivitis occurs. 2. - Increased vascular dilation and permeability - Infiltration of fluid - Collagen loss in sulcular epithelium and epithelial ridges form 3. - Edema/swelling and redness of marginal gingiva- gingival enlargement (signs of gingivitis) - Develops 4-7 days following plaque biofilm accumulation- biofilm is older and thicker (can vary e.g. 7-14 days)